What are the first signs of autism?
- low muscle tone
- developmental delay
What is interoception and do kids with autism have this?
- the sense that helps us feel what is going on inside our own body
- NO, kids w/ autism do not have this sense or do not understand it
How many months are kids with autism delayed?
2-3 months delay in gross motor milestones
What is a red flag that could indicate autism?
- loss of skills in the 5 domains w/in the first 2 years
What are some marked impairments in socio-communicative abilities and motor skills?
- delayed/absent language
- not pointing or seeking attention
- difficulty transitioning
- self-injury, tantrums, or emotional regulation
What happens to the brain in those with autism?
- increased brain volume (grey and white matter)
- increased head circumference at birth
- more CSF
- more cortical thickness
What is the neuroanatomy progression of autism?
decreased synaptic pruning -> early hyper-connectivity -> hypoconnectivity by adolescence
basically decreased synaptic pruning leads to overload and overstimulation
What are the 4 areas involved with the DSM-5 for autism?
- social impairment
- language/communication impairment
- repetitive/restricted behaviors
- sensory processing
What are the 3 levels of severity for the DSM-5 for autism?
Level 1: requiring support
Level 2: requiring substantial support
Level 3: requiring very substantial support
What are some parent reported red flags for autism?
- “He isnt that interested in moving, he likes to sit on my lap”
- “sam is such an easy baby”
- “he is such an independent baby, he doesnt like hugs”
- “he likes to shake toys or hit them on the ground”
What is the outcome measure to screen for autism?
M-Chat
- 20 items
- yes/no responses
- parent reported
What are the 2 components of autism disorder?
Motor:
- mild low tone
- dyspraxia/postural control deficits
- delayed milestones
Sensory:
- EITHER hyper/hypo active
- variable/unpredictable interoception
- idiopathic toe walking
What are some motor domain delays from infant to age 2?
- no smile/eye contact
- mild low tone (w-sitting)
- not affectionate
- regression of typical skills
- no words by 16 months
- no imaginative play
What are some motor domain delays from age 2-5 yrs?
- increased falls
- decreased endurance
- compensatory motor strategies
- doesn’t like tactile input
- Echolalic (repeating words)
- hyper/hypo-arousal
- beginning to see toe walking here (idiopathic)
What are some areas of concern regarding history of an autistic child?
- milestones
- coordination
- endurance
- dyspraxia
- self-regulation issues (sleeping, food preferences, tolerance to touch)
What is a good outcome measure to use for those with autism from birth to 14 yrs 11 months?
Sensory Profile 2
- birth to 14 yrs 11 months
- tactile, oral, visual, vestibular, kinesthetic, proprioception
What are some interventions for infants/toddlers w/ autism?
- postural control
- tolerance of vestibular input (rolling, moving positions)
- functional and graded sensory input
What are some interventions for preschoolers/young children w/ autism?
- structure
- floor play
- 1 toy at a time
- obstacle courses
- strength/endurance/vestibular training
- using pictures
What are some interventions for adolescents w/ autism?
- vigorous exercise
- aerobic + resistance training
- water aerobic conditioning
- yoga
What are the 4 power sensations?
- touch
- proprioception
- vestibular
- interoception
What are the 3 different domains of sensory processing disorder?
1) Sensory Modulation disorder
2) Sensory-Based Motor disorder
3) Sensory Discrimination disorder
What is involved with sensory modulation disorder?
Sensory over responsivity:
- threshold for sensation is too low
- overstimulation
- rigid (trying to create structure)
Sensory under responsivity:
- threshold for sensation is too high
- low registration for incoming data
- “clueless” child
Sensory craving:
- risk takers
- easily bored, seek out more every time
- disorganized and always moving
What is involved with sensory-based motor disorder?
Dyspraxia:
- difficulty planning/executing a skilled movement
- avoid sport -> sedentary lifestyle -> obesity
Postural:
- poor body perception in space
- poor proprioceptive feedback, core stability, and endurance
- slouchers
What is involved with sensory discrimination disorder?
Difficulty interpreting objects/places/people/foods
- mostly understanding all senses
- appear awkward, takes time to understand senses
-
Atypical Development and movement blocks23
-
Cerebral Palsy54
-
Prematurity51
-
Autism28
-
Developmental Coordination Disorder31
-
Down Syndrome & Hypotonia18
-
Gait impairments9
-
Myelomeningocele32
-
Duchenne Muscular Dystrophy (DMD)17
-
Spinal Muscle Atrophy (SMA)15
-
Peds Oncology27
-
Congenital Muscular Torticollis22
-
Educational Law11
-
Wellness and Health10
